Women are told to expect any number of symptoms with the menopause, and that it could come rather vaguely between the ages of 45 and 55. So it can feel reassuring to think there’s a test that can say you are definitely in the menopause, as this can help explain any particular symptom and point to treatment options. But is a simple blood test that straightforward? It can be hard to interpret, and other factors can be more reliable to guide you on whether you are menopausal, such as your symptoms, your age, how regular your periods are, and even what age the women in your family experienced their menopause.
Menopause occurs when your ovaries stop producing a hormone called oestrogen, and this happens for most around the age of 51. Your doctor may advise you to get blood tests if you are younger than 45 and are experiencing menopausal symptoms or your periods have stopped, as there are important conditions such as premature ovarian insufficiency or early menopause that will need further investigation and management.
A blood test will look at a hormone called FSH (follicle-stimulating hormone) and oestrogen. FSH helps manage your menstrual cycle as well as stimulating the production of eggs from the ovaries. Once you have reached menopause, FSH levels are high. However, when you are approaching menopause (termed perimenopausal), levels can fluctuate, so you could get a normal FSH result on that particular day, when in fact levels are going up and down but they are generally on the rise. As your ovarian reserve is declining, your oestrogen levels are also going down.
FSH level is not helpful for people who are taking contraceptives that contain oestrogen or progesterone, because these can affect the levels of your FSH, and also certain treatments for heavy periods. If your periods have completely stopped for at least 12 months after the age of 50, or for 2 years before the age of 50, this is more reliable to diagnose that you have reached menopause. Symptoms like hot flushes, sweating at night, vaginal dryness, changes to your mood, pains in your joints or muscles and finding sex sore or losing interest in sex, are typical as you go through hormonal fluctuations. These symptoms add to the diagnosis. Some women experience some of these, others none at all, some women find they are very affected, and for others symptoms are mild or fairly brief.